TY - JOUR
T1 - Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases
T2 - a multinational cohort study
AU - Cordova, Reynalda
AU - Viallon, Vivian
AU - Fontvieille, Emma
AU - Peruchet-Noray, Laia
AU - Jansana, Anna
AU - Wagner, Karl-Heinz
AU - Kyrø, Cecilie
AU - Tjønneland, Anne
AU - Katzke, Verena
AU - Bajracharya, Rashmita
AU - Schulze, Matthias B
AU - Masala, Giovanna
AU - Sieri, Sabina
AU - Panico, Salvatore
AU - Ricceri, Fulvio
AU - Tumino, Rosario
AU - Boer, Jolanda M A
AU - Verschuren, W M Monique
AU - van der Schouw, Yvonne T
AU - Jakszyn, Paula
AU - Redondo-Sánchez, Daniel
AU - Amiano, Pilar
AU - Huerta, José María
AU - Guevara, Marcela
AU - Borné, Yan
AU - Sonestedt, Emily
AU - Tsilidis, Konstantinos K
AU - Millett, Christopher
AU - Heath, Alicia K
AU - Aglago, Elom K
AU - Aune, Dagfinn
AU - Gunter, Marc J
AU - Ferrari, Pietro
AU - Huybrechts, Inge
AU - Freisling, Heinz
N1 - © 2023 Published by Elsevier Ltd.
PY - 2023/12
Y1 - 2023/12
N2 - BACKGROUND: It is currently unknown whether ultra-processed foods (UPFs) consumption is associated with a higher incidence of multimorbidity. We examined the relationship of total and subgroup consumption of UPFs with the risk of multimorbidity defined as the co-occurrence of at least two chronic diseases in an individual among first cancer at any site, cardiovascular disease, and type 2 diabetes.METHODS: This was a prospective cohort study including 266,666 participants (60% women) free of cancer, cardiovascular disease, and type 2 diabetes at recruitment from seven European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Foods and drinks consumed over the previous 12 months were assessed at baseline by food-frequency questionnaires and classified according to their degree of processing using Nova classification. We used multistate modelling based on Cox regression to estimate cause-specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations of total and subgroups of UPFs with the risk of multimorbidity of cancer and cardiometabolic diseases.FINDINGS: After a median of 11.2 years of follow-up, 4461 participants (39% women) developed multimorbidity of cancer and cardiometabolic diseases. Higher UPF consumption (per 1 standard deviation increment, ∼260 g/day without alcoholic drinks) was associated with an increased risk of multimorbidity of cancer and cardiometabolic diseases (HR: 1.09, 95% CI: 1.05, 1.12). Among UPF subgroups, associations were most notable for animal-based products (HR: 1.09, 95% CI: 1.05, 1.12), and artificially and sugar-sweetened beverages (HR: 1.09, 95% CI: 1.06, 1.12). Other subgroups such as ultra-processed breads and cereals (HR: 0.97, 95% CI: 0.94, 1.00) or plant-based alternatives (HR: 0.97, 95% CI: 0.91, 1.02) were not associated with risk.INTERPRETATION: Our findings suggest that higher consumption of UPFs increases the risk of cancer and cardiometabolic multimorbidity.FUNDING: Austrian Academy of Sciences, Fondation de France, Cancer Research UK, World Cancer Research Fund International, and the Institut National du Cancer.
AB - BACKGROUND: It is currently unknown whether ultra-processed foods (UPFs) consumption is associated with a higher incidence of multimorbidity. We examined the relationship of total and subgroup consumption of UPFs with the risk of multimorbidity defined as the co-occurrence of at least two chronic diseases in an individual among first cancer at any site, cardiovascular disease, and type 2 diabetes.METHODS: This was a prospective cohort study including 266,666 participants (60% women) free of cancer, cardiovascular disease, and type 2 diabetes at recruitment from seven European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Foods and drinks consumed over the previous 12 months were assessed at baseline by food-frequency questionnaires and classified according to their degree of processing using Nova classification. We used multistate modelling based on Cox regression to estimate cause-specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations of total and subgroups of UPFs with the risk of multimorbidity of cancer and cardiometabolic diseases.FINDINGS: After a median of 11.2 years of follow-up, 4461 participants (39% women) developed multimorbidity of cancer and cardiometabolic diseases. Higher UPF consumption (per 1 standard deviation increment, ∼260 g/day without alcoholic drinks) was associated with an increased risk of multimorbidity of cancer and cardiometabolic diseases (HR: 1.09, 95% CI: 1.05, 1.12). Among UPF subgroups, associations were most notable for animal-based products (HR: 1.09, 95% CI: 1.05, 1.12), and artificially and sugar-sweetened beverages (HR: 1.09, 95% CI: 1.06, 1.12). Other subgroups such as ultra-processed breads and cereals (HR: 0.97, 95% CI: 0.94, 1.00) or plant-based alternatives (HR: 0.97, 95% CI: 0.91, 1.02) were not associated with risk.INTERPRETATION: Our findings suggest that higher consumption of UPFs increases the risk of cancer and cardiometabolic multimorbidity.FUNDING: Austrian Academy of Sciences, Fondation de France, Cancer Research UK, World Cancer Research Fund International, and the Institut National du Cancer.
KW - Cancer
KW - Cardiovascular diseases
KW - Diabetes
KW - Diet
KW - Multimorbidity
KW - Ultra-processed foods
U2 - 10.1016/j.lanepe.2023.100771
DO - 10.1016/j.lanepe.2023.100771
M3 - Article
C2 - 38115963
SN - 2666-7762
VL - 35
SP - 100771
JO - The Lancet Regional Health - Europe
JF - The Lancet Regional Health - Europe
M1 - 100771
ER -
